The colors are soft and soothing, muted greens and blues, says Mary B. Gray, the administrator for psychiatry. With input from an art curator, peel-and-stick photos of Sullivan County — no glass or screws with the potential for improper use — decorate the walls.

By incorporating an underused adjacent area, the 18-bed unit now features single-occupancy rooms.

"It's what patients like — and should have," says Gray. "They're stressed. They don't want to see roommates. And then there are privacy and confidentiality concerns."

Furthering the sense of healing, and countering the stigma that equates mental illness with violence, is the accessibility of patients to staff — without barriers. Even the nurses' station is open.

"That makes it less frightening for the patient," says Gray. "The staff knows how to verbally de-escalate situations that might arise so frustrations don't become violent."

Along with aesthetics, the renovations key into safety. Looping risks, for example, from door hinges to radiators to the backs of toilets, have been addressed. And the work was done in two phases so as to minimally disrupt patients.

"The hospital was built in the '70s," says Gray — and without a designated behavioral health unit. "We've been using an 18-bed med-surg unit, which we made do with."

Last January, however, the board of directors identified as one of its priorities improvement in services for those with mental illnesses.

To be admitted to the Behavioral Services Unit, one must be in imminent danger of hurting him or herself or others. All patients are admitted through the emergency department.

While there are many manifestations of mental illness, Gray says they're seeing their fair share of middle-age,

middle-class people caught up in a cycle of loss — and have had enough.

Frequently, the pattern of decline is triggered by the loss of a job. The home is in jeopardy. Bill collectors are calling. The spouses start fighting. The kids are scared and start acting out.

"It's often the man who feels responsible. There might have been an attempt at suicide or an unwillingness to go on; 'I give up,' " says Gray.

The emergency department will do a screening for suicide risk. Or perhaps the threat is directed at the ex-wife or an ex-boss. If a substantial risk is determined by the psychiatrist, the patient is admitted.

"Most remain an inpatient for between 10 and 12 days. Although some have been here four and others 40," she says.

While initially soothing, the new space also amplifies the other healing services. Rather than a dining space used for multiple purposes, there are separate dining, consultation, conference and therapy rooms. If a patient wants space, there's a quiet room for reading or meditation, too.

Gray says they took a collaborative approach with Orange Regional Medical Center on this project.

"It's our sister organization and we want to be as close as possible in terms of policy, practice and protocol," says Gray. Even the color palette is the same. "Our goal moving forward is to provide the same treatment. Sullivan County is not a rich county. ... Catskill Regional does not have outpatient services as in Orange County. That is part of our strategic plan, for 2014, so as to be able to provide a continuum of care."

But a first step is providing excellent crisis care in a healing environment — close to home, she says. There are teams comprising the patient, social worker, nurse, nursing assistant and psychiatrist.

"You can't get the family involved if the family can't get there," says Gray. "We want to keep people out of the hospital. ... And there's a firm connection to that with the outpatient pattern. Patients say what they need to say to get out, but they often don't continue the after-care. ... Sixty percent don't continue their medications because of cost or side effects."

Although the hospital does not have its own outpatient clinic, they do a "warm hand-off" — involving family members or a caseworker who hopefully will ensure the patient continues treatment with either a county or private provider. Resource information is also provided as needed to assist with concerns such as food, shelter, substance abuse, etc.

The unit is generally full — and an increase is possible as the word gets about the improvements, says Gray, who indicates they've received state approval to go over census if need be, making a couple of the larger rooms double occupancy. Although not optimum, it's preferable to a patient staying on a gurney in the emergency department.

"With psychiatric facilities shutting down, we're fortunate to be able to offer this to the community. They deserve it and they need it," says Gray.

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